Kevin, M.D. - Medical Weblog

It is a bit of a rhetorical question, do parents have a financial incentive to get their kids labeled as autistic. There are school services, disability payments, extra time on tests and a whole host of benefits accrued to the person with the diagnosis of autism. Is it a surprise then that kid who were perceived as just a bit odd when I was in grade school would now be clinically labeled with a diagnosis?
Of course the incentive is there. It should surprise no one when people respond to the incentive
 

Newbie - good grief! Are you always so cynical or have I just dropped by at a bad time?
I think you'd have to be pretty desperate to sink that low, to volunteer to put your children through the torture and exposure of assessment just for a few measly dollars that don't even begin to chip at the enormous costs of bringing up an autistic child.
Don't suppose you have anything a little more cheerful to offer?
Best wishes
 

You need to close up shop for awhile and get around people who are not ill, and stop reading whatever articles you get this stuff from, because it is turning you into a terrible person.

Most people do not do this. A diagnosis of autism is devastating to most normal families. For you to parade around and make it sound like folks wants their kids to have this tells us that you are warped!
 

I'll have to come to his defense (not that he should need defending for raising the question).

Practicing psychiatry for 20 years now, I can say there is definitely an increasing trend for parents to unashamedly demand formal diagnoses for their children for the benefits that the system then confers on them. This really happens. I am not making it up. Calling me a terrible person isn't going to change it. It is not a cynical interpretation.

Children come in reporting hallucination etc. On interview some will say "Mama told me to say that so we can get a crazy check" or "Mama told me to fight so we can get money". This is from 6 year olds who did not pick up the idea of making this up on the playground.

Sometimes parents are the confessors being upfront about the need for the worse possible diagnoses on the chart. I had always been taught, and experience has confirmed, that a worse diagnosis should not be recorded until it is certain, because once recorded, it will never be questioned and will cause others to have a closed mind to that child's potential for doing better evermore.

It is the same with ADHD, parents will sometimes push for the diagnosis for the adavatages which the educational system confers on people with it. Some people are really impaired and need treatment, but come on, everyone is distractible, wishes they could concentrate better, and certain to perform better on timed exams with more time?

I didn't get this from articles. I get it from my own eyes and ears. The literature doesn't address this--because some people will call the writer a terrible person and academics don't want to deal with the controversy.

It is inevitable that when you create a situation that all you have to do is say certain things and act a certain way to get "free" money or services, some people are going to voluntarily engage in the behavior, who otherwise might not. The phrase "You get what you pay for" applies to entitlements as well. When you pay people for something you get more of it. We pay people to be pitifull, we get more pitifull people.
 

Where I work in Canada I see kids almost on a daily basis with teacher supplied diagnoses of ASD/Aspergers or ADD/ADHD and why?
The school boards get more funding and the teachers get a "teachers aide" in the classroom to help with the freshly created "special needs" kids and the parents get more welfare payments.It is called secondary gain.
Mcewen - you are hopelessly naive!
 

So because one criminal person uses her children in order to steal money from the government, do you suppose a huge number of parents would be able to do something that preposterous, and this would raise the autism rates. I'm sorry but as a parent of one of those recently diagnosed autistic kids, I find your post very offensive.

Not only our kids are evaluated by their doctors, they are also seen by specialists from the school district or state agencies for the disabled, before they are approved for services. My son has been seen by dozens of professionals and all of them confirmed the diagnosis. This involves months and months of waiting. Then when we finally get approval for services, the services our children get are specially designed for the autistic, in order to teach them how to talk and relate to other people, how to get dressed and go to the bathroom by themselves. Things that normal kids don't need, and I highly doubt that any parent of a normal child would go through all that painstaking process for services that are completely unnecessary to a child that already talks, plays with her peers and behaves appropriately for her age.
 

As a fellow physician, I must say I am impressed with your scholarship, Kevin. Using anecdotal evidence to prove causality. I must have missed that day in my research methods course.

On perusing your blog I see that you get a lot of things right. But on this one you're dead wrong. There is absolutely no evidence whatsoever that the majority of people diagnosed with autism are "faking it" or getting "updiagnosed" just in order to get benefits. DSM IV diagnosis has been widened, but patients are being diagnosed that were there all along, they just were labeled something else.

Since you've used anecdotes to prove your point, I'll use an anecdote to prove mine. I'm the father of two kids, one of whom carries the diagnosis of PDD-NOS. He wasn't talking when he was 26 months old. This despite my wife and I reading to him a minimum of 30 minutes each day, interacting and talking with him all the time, and singing to him. According to my old Harriet Lane handbook, that just doesn't cut it for making the appropriate language milestone. But I guess we asked him to "fake that".

Just as we also must have asked him to flap his arms, spin around in circles, and to pay attention to specks of dust but not people. We asked him to have meltdowns in restaurants and other public places such that we could not go out, to physically hurt from noises of normal volume, and to not be fully toilet trained despite being 7 years old.

But we've gotten so much out of it. Yes, we got some speech therapy from the state. We also have a psychiatrist that we pay for out of pocket, $15K spent on other evaluations and therapy, so called "autism experts" at his school that don't know diddly, two suspensions during kindergarten for non-compliant behavior, and $20K spent on legal bills to fight the school system when they threw him into a school for the emotionally disturbed rather than provide all those supports that you think we all get.

To Gasman, I can't believe after reading the story about your nephew on your blog that you would deride people that exhibit many of the same symptoms that your nephew did/does. Shame on you.

I love both of my kids, and I don't want or need anyone's pity. They are great kids, and both of them enrich my life in many ways. My son with autism has progressed markedly since first being diagnosed. But he is still autistic. It is part of who he is, and will be forever. He hasn't been "faking it", and neither are any of the other autistics that I am acquainted it.
 

The rise is nothing more than better diagnostic practices. Take my family....

My father and grandfather both missed getting diagnosed, but then my grandfather died in the early 80's and my father in the late 80's. Both were diagnosed with other disorders that are now know to as a common misdiagnosis for autistics who were diagnosed before autism was well known.

I myself made it to 34 before I was diagnosed (and that happened LAST YEAR.) So here I am an adult before I show on the numbers for my generation (something VERY common for autistics my age.) If I wasa kid today I would not have been missed, but back then all the school wanted to do was label me a retarded (and yes they used that word) and have me shunted into a program that would have lead to a slow death for me (autism does not guarrantee that one will be "mentally retarded".) My son is also autistic, but one school district missed it completely, and who knows how many more are in those schools not getting the help they need.

I will say, it's not fun growing up with autism, but it's also not as horrible as some people would like everyone to believe. Autism is on the rise because not only are we better at diagnosing it, but autistic are more likely to become successful and have kids of their own, and an autistic has a higher chance of having an autistic child than one of their non-autistic relatives does.

So how about instead of working on finding someone or something to blame for the rise in autism numbers why don't you work on good services and therapies that can help the square pegs figure out how to work in a world of round holes without having to hurt themselves.